Background Some authors have reported reductions in health-related quality of life (HRQOL) of hepatitis C (HCV)-infected patients, but studies fail to discriminate between the effect of factors such as the antiviral regimen, the viral load (VL) or the degree of fibrosis.
Purpose To evaluate HRQOL in chronically-ill HCV patients prior to, and after, treatment initiation
Materials and Methods Inclusion criteria: patients >18-years old, HCV antibodies+ and HCV-RNA+, no other relevant co-morbidities. Recruitment period: 9 months. Patients were stratified according to the previous VL and their degree of fibrosis, and started on antiviral treatment based on ribavirin + peginterferon. On their follow-up visits (weeks 0, 4 and 12), subjects were given a validated questionnaire (SF36) to be completed at home and delivered on their next visit to the outpatient pharmacy. SPSS v17 was used for the statistical analysis.
Results 18 subjects recruited (n = 18), percentage of males 67%, mean age 47.3. 10 patients had genotype 2 or 3, and 8 patients had genotype 1 or 4. Low-grade (stage 1–2) and high-grade (3–4) fibrosis was found in 11 and 7 patients respectively. 9 patients had >800,000 RNA copies/mL at presentation. With regard to the antiviral therapy, statistically significant differences in the following items were found between week 0 and week 4: physical functioning (P = 0.046), physical role (P = 0.001), pain (P = 0.001), health (0.046), energy/fatigue (P = 0.001), and emotional wellbeing (P = 0.001). Additionally, we found statistically significant differences in the emotional component with regard to the VL (P = 0.005) and the degree of fibrosis (P = 0.03).
Conclusions Antiviral therapy was associated with deterioration in HRQOL. Items involving physical health exhibited the greatest differences. Conversely, those subjects with higher VL and an advanced degree of fibrosis had worse scores in the items involving emotional wellbeing. Long-term studies are currently being conducted to determine whether the existing differences are emphasised over time, as well as the implications of these findings.
No conflict of interest.
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